Short-term safety evaluation of the offspring conceived by 7272 artificial insemination cycles with donor spermatozoon

Abstract

This case-control study was designed to investigate the safety of the AID technology. The health status of the offspring conceived by 1620 couples who underwent 7272 AID cycles in our Center for Reproductive Medicine between June 2006 and December 2012 was retrospectively analysed. The control group included 1018 women who naturally conceived and delivered in the same period. Twin birth rate was significantly higher in the AID group (no triplet birth) than in the control group (2.01% versus 0.39%, P < 0.01). In the AID group, Caesarean delivery was used in 1299 cases (81.65%), spontaneous vaginal delivery (18.04%) and forceps-assisted vaginal delivery (0.31%).There was no significant difference in male/female ratio of the offspring between AID and control groups (113.55 : 100 versus 113.36 : 100, P > 0.05). Compared to natural pregnancy, a pregnancy through AID resulted in higher multiple birth rate, premature delivery rate and neonatal congenital malformation rate. Increased multiple birth rate was attributable to ovulation induction, and increased rate of low-birthweight infants was related to multiplets and premature delivery. Caesarean delivery was preferred in couples who received AID treatment. The male/female ratio of the AID offspring was similar between natural pregnancy and AID pregnancy.

Update on: a meta-analysis of sperm donation offspring health outcomes – 2018 update

“…outcomes, only neonatal outcomes, and therefore cannot comment on any correlation with early obstetric intervention or delivery methods such as caesarean section. However, some studies did report higher incidences of caesarean section, 4,6,7 induction of labour 4,7 and forceps delivery, 4,6 in their donor sperm-conceived cohort which may have potentially been associated with those low birth weight incidences. These reported obstetric intervention increases nonetheless did not adversely affect the continuous outcome measures of mean gestational age or mean birth weight.…”

“…5 Furthermore, since the census date of the metaanalysis a further two studies have been published that also meet the criteria of our original review, 6,7 and we believed it was important that we add these three studies (two by other authors and one by ourselves), to our meta-analysis to see if the original findings were either supported or refuted.…”

“…All data extraction and analysis followed the method described in our original review. The studies that were included in each meta-analysis are listed as reference numbers in superscript after each meta-analysis.The updated meta-analysis has demonstrated that, in comparison to naturally conceived neonates, donor sperm neonates were at increased risk of being born of low birth weight (RR: 1.17, CI: 1.03-1.33, P = 0.02, I 2 = 52%), [3][4][5][6][7] and with increased incidences of birth defects (RR: 1.30, CI: 1.05-1.59, P = 0.01, I 2 = 72%) (Fig. 1).…”

“…1). 2,4,6 However, they were not at increased risk of being born preterm (RR: 1.05, CI: 0.91-1.21, P = 0.47, I 2 = 52%), [3][4][5]7 very preterm (<32 weeks) (RR: 1.17, CI: 0.75-1.81, P = 0.49, I 2 = 0%), 5,7 very low birth weight (<1500 g) (RR: 1.22, CI: 0.76-1.97, P = 0.4, I 2 = 0%), 5,7 small for gestational age (birth weight <10th percentile) (RR: 1.19, CI: 0.99-1.42, P = 0.06, I 2 = 82%), 5,7 large for gestational age (birth weight > 90th percentile) (RR: 1.04, CI: 0.86-1.38, P = 0.71, I 2 = 0%), 5,7 with altered perinatal mortality (RR: 0.93, CI: 0.59-1.45, P = 0.74, I 2 = 0%), 5,7 of lower mean birth weight (mean difference −12.5 g, CI: −32.03 to 7.02 g, P = 0.21, I 2 = 0%), 3,[5][6][7] or of lower mean gestational age (mean difference −0.02 weeks, CI: −0.10 to 0.05 weeks, P = 0.55, I 2 = 12%). 5,7 Of the newly included studies, one appropriately stratified data into singletons v. multiple deliveries, 5 whereas another only analysed singletons 7 to remove confounding from multiple births.…”

“…All three studies reported maternal ages, two of which adjusted for maternal age, 5,7 whereas the other had no significant difference between maternal ages of those conceiving with donor sperm v. spontaneous conception. 6 Parity was appropriately adjusted for in two of the newly included studies. 5,7 Caution should be taken when interpreting these results.…”